Agenda item

Officers will be in attendance to provide an introduction in respect of how the local authority can use economic development to improve health and reduce health inequalities.

The Chair reminded Members then when agreeing the 2020/21 Health Scrutiny Panel’s work programme, the main topic selected was inclusive growth – alignment of town centre regeneration and health goals. A number of representatives had therefore been invited to attend today’s meeting to provide a setting the scene presentation in respect of this topic. The expert guests included the Director of Public Health (South Tees) and the Public Health Business and Programme Manager. 

The Panel heard that since 2015, Middlesbrough had been identified as the most deprived area nationally (based on proportion of lower super-output areas within the 10% most deprived). The recent Marmot Review highlighted that previous increases in life expectancy in the area had worrying declined or stagnated in the last decade. Indeed the previous year-on-year improvements in life expectancy observed in Middlesbrough between 2001-2003 and 2011- 2013 had mainly been driven by gains in the affluent wards across the town, with the deprived wards showing very small changes in life expectancy in the last 15 years.

It was explained that in the run-up to COVID-19, a national paradox between growth in employment and GDP, in the face of entrenched poverty, low quality jobs and poor income and living conditions, had cast a light on the unequal distribution of economic progress. Good health was not however just a product of a thriving economy, it was a necessary contributor to it. A recent LGA report highlighted the cost of poor health on the economy, presenting some of the annual costs experienced nationally as a result, this included:

· Over £100 billion a year in productivity lost due to poor health;

· £42 billion a year in workforce costs attached to mental health issues;

· c£4.8 billion a year costs of socio-economic inequality on the NHS; and

· £15 billion worth of sick days

COVID-19 would undoubtedly amplify the economic costs outlined above, with early findings from the crisis additionally pointing to the unequal distribution of the direct and indirect impacts of the virus across socioeconomic lines. Higher number of death from COVID-19 in people living in socioeconomically deprived areas had been observed from as early as May 2020, with some studies suggesting that people residing in poor areas were more than twice as likely to be killed by the virus as those in the richest areas.

In addition to the above, the control measures enforced to stem the virus have had broader implications on income and job security. The IFS has suggested that (excluding key workers) the majority of the people in the bottom tenth of earning distributions, correlate to sectors that have been shut down as a result of COVID. When those who are unlikely to work from home are included within this, it is estimated that job security of c80 per cent of low income earners, have been indirectly affected by the pandemic. As key determinants of health, these impacts were likely to have a significant influence on a person’s ability to live a healthy live and would invariably translate to increased risk of premature mortality and morbidity that extended beyond the immediate risk of the virus.

The Public Health Business and Programme Manager advised that Councils and Combined Authorities have a significant role to play in developing inclusive economies. By embracing place-based approaches - that acknowledge the collective role of policy, services and communities in maximising the potential for shared prosperity and growth – shared economic development and public health approaches, can play a critical role in securing a fair and thriving borough.

Six high-level areas of prioritisation in promoting inclusive economies had emerged from the evolving evidence base, these have been outlined below and sit alongside a wider call for improved engagement between economic development functions and public health

·         Building a thorough understanding of local issues, to affectively diagnose the challenges and levers to inclusive economic growth and to better understand the impact of growth policies across population groups (e.g. BAME communities);

·         Having a long term vision and strong leadership, underpinned by a desire to design local economies that are good for people’s health- including rebuilding economies in a way that takes stock of the lessons learnt from COVID-19;

·         Building strong citizen engagement to inform priorities and strategies, in a way that builds community momentum and meets local aspirations;

·         Capitalising on local assets and using local powers more actively – including harnessing local government powers to shape economic conditions and capitalising on key assets such as, industrial sector, cultural heritage, natural environment and anchor institutions;

·         Cultivating engagement between public health and economic development;

·         Providing services that meet people’s economic and health needs together.

It was advised that the imperatives outlined above for improved alignment between health and wealth provided a critical starting point for prioritising action at the local government level. It was recommended that the Health Scrutiny Panel consider the high-level actions outlined and incorporate these in their draft terms of reference for the review to ensure that the Council’s ability to shape conditions for inclusive economies are fully harnessed and to identify ways in which improved alignment can be achieved between strategies to address health and economic development.

AGREED that the information presented be considered and incorporated as part of the Panel’s review on this topic.